1825 Hickory Ln 2014 Fence CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000999 Date 7/07/14
Property Address . . . . . . 1825 HICKORY LN
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
replace 6 ft fence and gate
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Owner Contractor
------------------------
------------------------
STORY, GRAHAM NASH OWNER
1835 HICKORY LN
ATLANTIC BEACH FL 32233
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Permit . . . . . . FENCE PERMIT
Additional desc . . Plan Check Fee . 00
Permit Fee . . . . 3S . 00
Issue Date . . . . 7/03/14 Valuation . . . . 0
Expiration Date . . 12/30/14
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 3S . 00 3S . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 35 . 00 35 . 00 . 00 . 00
PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
N
2233
1
1845 2 0 20142
JobAddress: . it lev
Legal Description C.1.t� Gir htlaiiric Redc-11
MSTOMER KEMIF—i
GpeF. AT,LULk T�pe.- GL' DF&rt1_-_ S F—t
Valuation of Work$4,e2- W. RectFzp� aG. 660to -heated/co
1)d Uf. I/UX I I non oled 01A
YE,IF NiGur-, 7-
33:3
Class of Work(circle one): New olition pool/spa window/door
LAMIC DEACH, FL 32233
Use of existing/proposed structure(s El -— ---
If an existing structure,is a fire spri No N/A
Florida Product Approval#
For multi le products use product T&idef��dEtli I
p 17 $35.OU
VU
Describe in detail the type of work NCE;
lGtd, pcl�fl-jefj t $,3J.
I---__ I
1 I'dT ft� Ud Ltf. 1 0311 i4
Property Owner Information:
Name: �Address: r,
City 6r\l p
p hone #�-j 2,4C!
�State�i Tg!�
E-Mail or Fax#(Optional
Contractor Information: ��VX
Company Name: Qualifying A t:
Address: Ci State Zip
Office Phone Job Site/Contact Number —.—Fax
State Certification/Registration
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
d it do th f
re na e a a ,ermit o the work and installations as indicated. Icertiy that no-work or installation has commencedprior to the
11 , r
-V 00't '�k P be erformed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
m and tha a wo' w
,�,edt tj
hi S' (.6 months, or if construction or work is sits ended or abandonedfor a period of sixJ6 fter
a 5'1_s it ot om t� dfor Electricarwork,Plunibing,Sikns, Wells,Pools,
� k
pp 'io ' '
issuance 0 p
and oidif , 'i
.0 is'o . ", I it "t", t at months at any time a
,k e d. nde d h epa ate permits must be secure urnaces,Boilers,Heaters,
Tanks andAir Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
'here certify that I have read and examined th* qpolication and know the same to be trite and correct. 411provisions of laws and ordinances governing this
ype o7lwork will be co�npl'ed wit�whether s elc8ifz'ed herein or not. The granting of a permit does nut presume to give authority to violate or cancel the
)rovisions of any otherfede 1,state r local aw regulating construction or the pe�formance of constru,";G�1.
;ignature of Owner Signature of Contractor
rint Name
Print Name
.........................
Before me
71, ed w,,r,,,
8
e t
. ........................
of 9IM/K 99jidxq _ft-A-AD this Day of
990:14,P0!qq6dW03 AVV r
Rnt 0 y
I L, Notary Public
Revised 1 0_24 19.
f BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 JUN"
Office (904) 247-5826 Fax (904) 247-5845 20 2014
2 t2014
�13y
Job Address: (A CV_C� A9. Permit Awi6��,
I
Legal Description Floor Area of S Parcel#
hq.Ft. Sq.Ft
Valuation of Work$42- Proposed Work eated/cooled non-heated/cooled OIL
Class of Work(circle one): New Addition Alteration 09;D Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Ce—s i—d-e7t�-
If an existing structure,is a fire sprinkler system installed? (Circle.one): --Ye—s No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: FEYLP1CZ- ENS-Pa- FEWCE
mass nnU
Property Owner Information: t ILE r i
Name: Address: -C 12-1.0-
7 77'
State ip 3Phone
04 26� S�0 ar C7
E-Mail or Fax# (Optional)
Contractor Information: )4)
Company Name: Qualifying A t:
Address: city —State Zip
Job Site/Contact Number Fax
Office Phone
State Certification/Registration
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
,e and Address
I
Bonding Company Name and Address
Mortgage Lender Name and Address
m it do the work and inst"
r
0 om tt s
Application is hereby made to obtain a permit o the work and installations as indicated I certify that no work or installation has commencedprior to the
issuance of a permit and that all work will be erformed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes mill
it i or if co 'tr'cl -aW ter
'thin s' ((6)months, or if construction or work is suspended or abandonedfoi eriod of sixpo)months at any time af
and void if work is not commenced within s urnaces,Boilers,Heaters,
work is commenced I understand that separate permits must be securedfor Electricar Work,Plumbing,Signs, ells,Pools,
Tanks andAir Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Ihere certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
work will be co�nphed wit hether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
type.I/V
provisions of any otherfede 1,s t , r local law regulating construction or the pe�fbrmance of construction.
Signature of Owner Signature of Contractor
PrintName Print Name ........................................................................................................................................
... ........ ......... ...........
Befor Before me
Dayof 9LOV37-L sandx this —Day of .20
990:10.uom wooAIN
11affie Aapjt4q
No a u Notary Public
Revised 10.24.12
CITY OF ATLANTIC BEACH
(OWNER / BUMDER AFFH)AVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION
CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED
CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT
LAW. TTIE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY.TO ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR
TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING
MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHN ONE YEAR
AFTER TBE CONSTRUCTION IS COMPLETE, TBE LAW WILL PRESUME THAT YOU BUILT
IT FOR SALE OR LEASE, WIHCH IS IN VIOLATION OF TfUS E)TEMPTION. YOU MAY NOT
IfIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR- YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO TBE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX ANDIOR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(l). AN-OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
I
ADDRESS PHONE NUMBER
PRMT NA
M�l
SIGNATU DATE
Before Z�7dy of-,--". 20Lq1n the county of
Duval,State of Florida,has personally appeared herin by hirriself herself and affirms that
all statements and de��ptions are true and ccurate.
Notary Public at Large,State of County of 9LOZ/tvao s9jidx3 11490
066990:J-A u0inowwoo Avy
0 P monally Known w8k4eic)1 AqpqS
Xmduced IdentiL ion- % —
sPi.joijo ems ownd-AJ94ON .0v
Notary Sig L
FIBIDG/0��-Build.r Affadavi�REVISI: 4/16/20U
C REPLAT
L 8 SELVA MAP,INA U N N 0
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RD RED BY:
The Law Offices of Rod Schloth
2187 S Third St
JacksonviLle Bch, FL 32250
904-372-9351
beach@ rod-taw''com
kL
PROPERTY ADDRESS: 1825 HICKORY LANE ATLANTIC BCH,
T
FIELDWORK DATE:311EV2013 REVISION DATE(S):(REV 3/18/2013)
LL,
t C-1 TABLE:
FL 1303.0951 E2
BOUNDARY SURVEY P,=50.00'(P4-C) L-) N 0*24'53"W I O.00r(D)
P R:C
FI�L
�,$Li-- L=39.27'(P#,C) N 0"56,45"E 10.00(M)
DUVAL COUNTY I--
A=45'0900'(1`4�C) L-2 N 0'24*53"W 2.00(D)
1> CM=N 22'05'07"E,38.27'(P*C) N 0'2 I'l I'W 2.02'(M)
"D DT j�S
i,rlF,:
N 89134'48*If 79.84'(C) NC ID
=tc) Qti N 89'35U7"E 79-95'(P) 40 @ F.R M. I
1-Q CV. — 5iRC
V— �z ��LB#7337
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30, 2 U a 0 15 30,
GWHIC 5CALE
I inch 30 feet
Zf-
I hereby certify that t i f "A described properTy has
been made uncier' 10.n;f Ikeo st of.Ty\,knowledge and belief,it's
a true and accurate r p e 0 s6vey that j*ts:he minimum technical
standards set forth b e Land Surveyors as
described in Chapter I of �Iminis ve Code,
C STA E C
FLORIDA /;�/
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a, vv i k1i
Wesley B.Haas
fessiorkostmyoravcva�vef
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-lcense 4o,3708
,i9 be at- —jsers Sole Ris�-A Without fabilint to the Surveycr
cj is 5,ey for Purpctes other tna�intended,
Nothing hefton shall be co,
City of Atlantic Beach APPLICATION NUMBER
2 Building Department be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Oate routed:
E-mail: building-dept@coab.us
L
City web-site: http://Www.coab.LIS
APPLICATION REVIEW AND TRACKING FORM
Y2, 4 Z-71 Department review required Yes No
Property Address: ;�7 /�j;
&Zoni
Applicant: 3
Tree Adirl!.nistrator
�91=7V �k_s
Project: :>
;FUT MCT.i 1:M;�
Public Safety
0 Fire Services
9
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Recein' Date
of Permit Verified c.,Y
Florida Dept. of Environmental Protection
Florida Dept. of Transportation -
St. Johns River Water Management District
Army Corps )f Engi ieers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: ZApproved. ElDenieut
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by-'do/_
Date:
TREE ADMIN. Second Review: nApproved as revised. E]DeniE
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. nDeniE
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
o be assigned b the Building Department.)
Building Department
800 Seminole Road 11REC J-\,7FD W-
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845JUN 2 3 2014 )ate routed:
E-mail: building-dept@coab.us j L
City web-site: http://Www,coab.LIS
APPLICATION REVIEW AND TRACI � 'NG FORM
Property Address: lf2- Departi nt review required Yes No
Applicant: BuildiLl, z7Z,��
Tree Administrator
ep, h=1irworks
Project: gmu—C U F,T,F-Ii�P
C3 Fire Services
Public Safety
9011
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Recei Date
of Permit Verifiee
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Divisbn of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: �Approvecl. E]Denieu.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: FlApproved as revised. F]DeniE
C Comments:
PUBLIC U
Date:
PUBLIC SA E Y Reviewed by:
FIRE SERVICES Third Review: FlApproved as revised, DDeni,
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by e Building D partment.)
800 Seminole Road i
Atlantic Beach, Florida 32233-5445
........ -----
1111p
Phone(904)247-5826 - Fax(904)247�5845 JUN 2 3 2014 -)ate rol 1:
E-mail: building-dept@coab.us
City web-site: hftp://www.coab.us IBY:--
APPLICATION REVIEW AND TRAC"'[�'lNG FORM
2, :5' 1' C Depart �i.(-.,nt review required Yes No
Property Address: Buildi
lanning .Zoni
e� eview re
67" _qfired
"2,
p rt 'E-!It r
B u ild i
annin�7�.Zoni
Applicant: Tree Ad %��istrator
Works
Project: u 1C L".;i �
Fire Services
Public Safety
Review fee $ Dept Signature /-<-
- Review or ece!
Other Agency Review or Permit Required of Permit Verified y Date
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: [VApproved. ODenieu.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Dat4�-)
TREE ADMIN. Second Review: FlApproved as revised. RDeniE
PUBLIC WORKS Comments:
PUBLIC UTILITIES Reviewed by:_ Date:
PUBLIC SAFETY
FIRE SERVICES Third Review: FlApproved as revised. 0DeniE
Comments:
Reviewed by: Date:
Revised 05/14109